Spot specimen testing with GeneXpert MTB/RIF results compared to morning specimen in a programmatic setting in Cotonou, Benin-Reference-Cited by-同舟云学术

Spot specimen testing with GeneXpert MTB/RIF results compared to morning specimen in a programmatic setting in Cotonou, Benin

Published:2021-09-20 Issue:1 Volume:21 Page:
ISSN:1471-2334
Container-title:BMC Infectious Diseases
language:en
Short-container-title:BMC Infect Dis

Author:

Massou Faridath,Fandohan Merlin,Wachinou Ablo Prudence,Agbla Schadrac Christin,Agodokpessi Gildas,Rigouts Leen,de Jong Bouke Catherine,Affolabi Dissou

Abstract

Abstract Background The diagnosis of tuberculosis (TB) using smear microscopy has been based on testing two specimens: one spot and one early morning sputa. Recently, the World Health Organization (WHO) has recommended to replace, whenever possible, microscopy with GeneXpert® MTB/RIF performed on a single specimen. However, as the bacterial load is higher in early morning specimens than in spot specimens, one could expect lower sensitivity of GeneXpert® MTB/RIF performed only on spot specimens. In this study, we compared results of GeneXpert® MTB/RIF on spot specimens versus early morning specimens, under programmatic conditions in Cotonou, Benin. Methods From June to September 2018, all sputa received from presumptive TB patients at the Supranational Reference Laboratory for Tuberculosis of Cotonou were included in the study. From each patient, two specimens were collected (one spot and one early morning) and GeneXpert® MTB/RIF was performed on both specimens. Results In total, 886 participants were included in the study, of whom 737 provided both sputa and 149 (16.8%) gave only the spot specimen. For the 737 participants who provided both sputa, GeneXpert® MTB/RIF was positive for both specimens in 152 participants; for three participants GeneXpert® MTB/RIF was positive on spot specimen but negative on morning specimen while for another three, the test was positive on morning specimen but negative on spot specimen. The overall percentage of agreement was excellent (99.2%) with a positive and negative percent agreement greater than 98%. Conclusion For TB diagnosis under programmatic conditions in Cotonou, GeneXpert® MTB/RIF in spot specimens gave similar results with the test in morning specimens. Performing GeneXpert® MTB/RIF in both specimens did not significantly increase the number of cases detected. To avoid losing patients from the diagnostic cascade, it is preferable to test sputa produced at the time of the first visit at the health center.

Publisher

Springer Science and Business Media LLC

Subject

Infectious Diseases

Link

https://link.springer.com/content/pdf/10.1186/s12879-021-06676-6.pdf

Reference26 articles.

1. World Health Organization (WHO). Global tuberculosis report. Geneva: World Health Organization (WHO); 2020.

2. Organisation Mondiale de la Sante (OMS). Le traitement de la tuberculose: principes à l’intention des programmes nationaux. Geneva: Organisation Mondiale de la Sante (OMS); 2003.

3. Mase SR, Ramsay A, Ng V, Henry M, Hopewell PC, Cunningham J, et al. Yield of serial sputum specimen examinations in the diagnosis of pulmonary tuberculosis: a systematic review. Int J Tuberc Lung Dis. 2006;2007(11):485–95.

4. Leonard MK, Osterholt D, Kourbatova EV, Rio D, Wang W. How many sputum specimens are necessary to diagnose pulmonary tuberculosis? Assoc Prof Infect Control Epidemiol. 2005;33:58–61.

5. Sarin R, Mukerjee S, Singla N, Sharma PP. Diagnosis of tuberculosis under RNTCP: examination of two or three sputum specimens. Indian J Tuberc. 2013;48(13):2–5.